170348 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: 361189 Page 1 of 1
ONE CIVIC SQUARE COCA COLA ENTERPRISES BOTTLING CRECK AMOUNT: $452.20
CARMEL, INDIANA 46032 2329 PAYSPHERE CIRCLE
CHICAGO IL 60674 CHECK NUMBER: 170348
CHECK DATE: 4/1/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE A DESCRIPTION
0 1047 4239040 3366314803 452.20 FOOD BEVERAGES
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STATEMENT OF ACCOUNT
Refer to: 0095143665
CARMEL CLAY PARKS AND RECREATION
THE MONON CENTER
1411 E 116TH ST
CARMEL IN 46032
i
95143665 1 04 March 2009 1 of 1
Invoice Invoice Date Due Date Purchase Item Amount
Number Order/ Type due
Reference
i
Store No. MONON CENTER Sold To 1632600 I
1195 CENTRAL PARK DR, CARMEL, IN, 46032
3366313205 02/06/2009 03/15/2009 INV 1,012.10
3366313706 02/13/2009 03/15/2009 INV 192.30
3366314803 02/27/2009 03/15/2009 INV 452.20
Sub Total 1,656.60
Past Due USD 0.00
Total Amount Due USD 1,656.60
Any questions or communications regarding this statement contact:
Bruce Lint
A COCA COLA.ENTERPRISES BUIfLER
NVO 1 CE PAGE 1 OF 2
SHIP TO: REMIT TO:
MONON CENTER IRI-SIAILS COCA-COLA BOTTLING
CARMEL CLAY PARKS 8 RECHEAIIUN INDIANAPOLIS SALES CENTER
1195 CE=NTRAL PARK OR 2329 PAYSPHEHE CIRCLE
CARMEL IN 46032 CHICAGO, IL 60674 -2329
317-243-3771
0tJ TLE f "1 63'260 1 NVO I CE# 33663 14803
AR# 1632600
RTE- 375 URIVEH- 3707 LOAD- 1SLi13 SEW 00003 1_1 Al t= fl "1_ 127 J09
DOE'# 33663148130 PL- 101 LIME: 08:13:17 CHARGE NET 15 PROX
SHELL BALANCE i2`i0
PALLET AMC b U2 49
MICHELLE
SALES
UESCHIPIIUN ART# OIY PRICE ADJ# HATE NEI EXIENUED
DASAN I -"24 BOTTLE CASE
20PET24L DASANI WATER 5063 4 34.00 3544 -18.15 15.85 63.40
SUBTOTAL 4 63.40
2002 PEI LS CSO W /TEA (NO /DEP)
20LSPTSPRP1Y SPRITE 4320 2 34.00 3544 -12.81) 21.20 42.40
20LSPEfS CNTR CLASSIC 5788 2 34.00 3544 -IZ.80 21.20 4
2()LSPSCfR ZERO COLA COLA 0377 2 34.00 3544 -12.80 21.20 42.40
2ULSPETS CNTR DIEI C11KE 5789 2 34.00 3544 12.80 21.20 42.40
20LSPETS CNTR CHRY LUKE 5790 2 34.10 3544 12.60 21.20 42.40
SUBTOTAL 10 212.00
20OZ PE 1 LS I -'OW __HAIJL_ NO /Ot-P
ZUPTLWM POWERADE FPUNCH 5995 4 34.00 3544 -11.90 22,10 88.41
20PTLWM POW MOUNTAIN BLA 4035 4 34.00 3544 -11.90 22.10 88.40
SUBTOTAL 8 176.80
DEPOSITS ON SALES
UESCHIPIION AHI# UTY PRICE ADJ# HAIE NEI EXIENUEU
SHELLS 16120 OZ 0606 10 0.00 <.<IMPLIED 0.00
SUBTOTAL 10 0.00
G'
CONTINUED
A CLICA COLA LNILHPRISES HUIILLR
INVOICE PAGE 2 OF 2
SHIP TO: HEMII TO:
MUNUN CENILi( IHI-SIAILS COCA-CULA HUIILING
CAHMFI. CI AY PARKS 8 HLCRLA 11 I IN I NU I ANAPI IL I S SAI FS CEN I FH
1195 CENTRAL PARK OR 2329 PAYSPHEHL CIRCLE
CARMEL IN 46032 CHICAGO, IL 60674-2329
317-243-3771
OtJ T LE T 163261M.l I NVO I CE& 33663 "14611;3
AR# 1632600
RIF- 375 URIVER- 37117 WALI- ISL03 SEU UUIIIl3 DAl E 02 /'27
OUC# 33663148030 PL- 101 IIME: 08:13:17 CHARGE NET 15 PHOX
SHELL BALnNCE 25. 22`105
PALLET SALANC u;Ns
MICHELLE
NEI PRODUCT UIY 22 TOIAL PRODUCT 748.00
TOTAL ADJUSTMENTS -295.80
SUB-TOTAL 452.20
0119683083001
AMOUNT DOE 452.20
THE UNUEHSIGNLU CONFIRMS AGREEMENT
10 1HE TEHMS AND CONDITIONS AND IS
AUTHORIZED TO SIGN.'
ROUTEPERSON' CUSTOMER
LAST PAGE
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Coca Cola Purchase Order No. 19075 P
361189 Tri- States Coca -Cola Bottling Center
2329 Paysphere Circle Date Due
Chicago, IL 60674 -2329
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2127109 3366314803 Concessions PO 19075 452.20
Total 452.20
1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk- Treasurer
Voucher No. Warrant No.
Coca Cola Allowed 20
61189 Tri- States Coca -Cola Bottling Center
2329 Paysphere Circle
Chicago, IL 60674 -2329 In Sum of
452.20
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1047 3366314803 4239040 452.20 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
12 -Mar 2009
Signature
452.20 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
I